Provider Demographics
NPI:1497700983
Name:LATONA, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LATONA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8071 TOWNSHIP LINE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2601
Mailing Address - Country:US
Mailing Address - Phone:317-357-8663
Mailing Address - Fax:317-376-1841
Practice Address - Street 1:8071 TOWNSHIP LINE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2601
Practice Address - Country:US
Practice Address - Phone:317-357-8663
Practice Address - Fax:317-376-1841
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2025-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01044242A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400038070OtherMEDICARE ID
IN200058110Medicaid
IN300097366Medicaid
IN200058110Medicaid